As leaders in the verification industry, we know that a smart process is the secret to seamless verification. Our comprehensive 4-step process ensures success from beginning to end.
Learn MoreStep 1
In defining eligibility, a comprehensive understanding of a company’s healthcare Summary Plan Description (SPD) is required. Our professionals work closely with your human resources department to understand dependent types and eligibility guidelines as they’re defined in the SPD. We use this information to establish eligibility rules and determine what types of documents are required to verify dependent eligibility.
Step 2
We manage the collection of documents for the verification process, making it easy for employees to submit via scan/upload, fax and mail. We then use a fully automated system backed with the most advanced OCR technology to process scanned data and verify eligibility as set by your eligibility rules.
Step 3
Communication is everything when it comes to employee participation in dependent eligibility verification. We create customized communication campaigns based on each company’s specific needs and culture, and while each specific communication is unique, the typical process includes the following elements:
Notification: Employees first receive an initial communication, either in email or letter format, to inform them that a dependent eligibility audit is occurring at their place of employment. Here, we provide information that explains how the process will benefit them, what documentation will be needed and a timeline for verification.
Education: Information is sent to help educate employees on what constitutes a “dependent”. If employees learn that they have dependents on their plan that don’t meet the eligibility requirements, they have the opportunity to remove them from the plan without question or consequence by using the Online Employee Interface.
Reminder: As the deadline approaches, employees receive reminders to submit their documentation if they haven’t done so already.
Results and Appeal Process: Once the verification process is completed, employees receive their results. If they believe the results are inaccurate, they’ll have the opportunity to appeal the decision at that time. If a dependent is found to be ineligible, the employee is provided a selection of alternate, affordable healthcare plans where the dependent could be eligible for coverage.
Call Center Support: Throughout the process, and if you elect, our call center staff can be available to assist employees in finding the correct documentation and answer any questions they may have.
Online User Interface: Employees are able to view the status of their verification and all communications related to their account via our easy-to-use online portal.
Step 4
Dependent eligibility verification is an ongoing issue. Statistically, the percentage of new hires with ineligible dependents is more than double that of the initial employee screening. Verifi1 encourages companies to conduct ongoing dependent eligibility verification on an regular basis. We conduct verification for all new hires as well as employees who have made a change to their dependent status during the previous enrollment year.